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Home My WebLink AboutHILLCREST BLK 6 LT 1LI GP'&.TER ANCHORAGE AREA BOROU'~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 N? 704 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION MAILING ...... ADDRESS *t"'~dY~"~'~-'~.,, /~JCJ/~, PHONE__ LEGAL DESCRIPTION~//-'r/ ¢E~_~:.¢~"' ~ w:-,., /A/~¢¢ .:~' : , SE~ZT-fC TANK: //..;:,~../:?/.4/~mr DISTANCE FROM WELL .;:' LIQUID CAPACITY z/ ,.f': z:;' ,.c., GALLONS, NUMBER OF MATERIAl ~-~. z- ..~ k.~?/..-~.'/~'~, ~.~ COMPARTMENTS LIQUID INSIDE LENGTH ~'-'- INSIDE WIDIH :~ DEPTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS LINING MATERIAt NEAREST LOT LINE OUTSIDE DIA~M_F~TER~,.. ,_ OR WIDTH , LENGTH , DEPTH CE FROM WELL _- -- -- - ..... ~J~LI~I'~-~- ~F-OIJNDATION.__ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: ///.-4:' DISTANCE FROM WELL , F_OUNDA~I©N NEAREST LOT LINE--. NUMBER OF LINES /../¢~ D STANCE BETWEEN L N TRFNCPI-WIDI:~I~ ' ABSORPTION AREA .// ~ DEPTH: TOP OF TILE TO FINISH GRADE .DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE ~':k~' ~';" '"-' :'~- ¥;" (¢'<¢'~" '/" '::"'~ ~ DISTANCE FROM WELL: .Z/,/z:y,~2..'/.-.~).-:., DEPTH ": TYPE , BUILDING FOUNDATION, NEAREST ~ ......SEPTIC ~_~¢. SEEPAGE LOT LINE '~'"~-'" , SEWER LINE , TANK , SYSTEM. - WATER __SAMPLE___, NEAREST ~.,- OTHER , CESSPOO{ , SOURCES DIAGRAM OF SYSTEM DISTANCES: ,z4 ~ 1' ~.. ~' ~, !Il, pJ GREATER ANCHORAGE AREA BORuUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 2'79-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: "~ TANK TYPe AND SIZE OF FACILITY TO bg SERVED SOil TEST RESULTS MAIL~ING ADDRESS~/~:~/ ~/¢¢'~/ '~X//~'~J/~ ~¢/¢'~/'~PHONE NOTE~ THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. /? //~- ~/>-~/~ "), TYPE SEPTIC TaNK SIZE ----~;2 TYPE K MINIMUM DISTANCES, REQUIREMI'-NTS FOUNDATION TO ~ TANK FOUNDATION TO SEEPAGE Pit , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL ~TC TANK, ~ SEEPAGE PIT , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC 'TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. H EAL~H AU~"F~RtTY OR LICENSED DESIGNER SEEPAGE AREA SIZE DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.